TECH189-1210: Initial Assessment and Management of Critical Patients

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INSTRUCTOR(S): David Liss, BA, RVT, VTS (ECC)

COURSE OPEN: December 30, 2010-February 6, 2011

REAL TIME SESSIONS: Thursdays, January 6, 13, 20, and 27, 2011; 12:00pm-1:30pm ET (USA)
Course RTS Times in Your Area: World Clock Converter
Practice Sessions: In order to prepare you for a successful experience in your CE course, we request you attend a practice session prior to the first RTS. Times and dates will be listed in your course confirmation email. Expect to spend up to 1 hour at one of the 2-4 practice sessions held prior to the first RTS.

Level and Prerequisites: All members of the veterinary support staff may join the course and its discussions; however, this course is focused toward veterinary technicians, veterinary assistants and ancillary staff working in small animal emergency facilities or in general practice with emergency caseloads. Note that the Real Time Sessions for this course are during the daytime USA time to be most available for those working swing and 3rd shifts at emergency facilities.
VSPN CE course: open to all VIN members and VSPN members. This course has been submitted to RACE for approval for veterinary technicians.

Course Description:
Handling critical patients from the moment they walk in the door is an essential skill for any veterinary technician. This course will NOT focus on long term management of critical patients, but rather the first few minutes of the arrival of a critical patient to your doorstep. Triage, CPCR, Initial assessment, venous access, and other vital techniques will be discussed. The focus will be on TPR and vital signs, recognizing signs of shock, initial assessments for: GDV, Urethral obstructions, and Trauma patients, and recognizing and dealing with arresting patients. This class will be for all levels of veterinary technicians and aims to increase their knowledge with regards to emergency care.

The course consists of four (4) real time interactive sessions of ninety minutes (90) each covering discussion of situations; multiple choice homework quizzes; and interactive message boards to discuss the real time sessions. Multiple choice homework quizzes will be given online each week; the goal of the quizzes is to test the participant's knowledge of the material covered discussed in each session and presented in the handouts. This course will include audio in the Real Time Sessions in addition to our regular features.

Upon completion of this course, the participant should be able to

• recognize a patient in shock.
• discuss key points in the initial assessment of critical patients.
• discuss parameters for and demonstrate quick response in any emergency situation.
• recognize signs of impending cardio-respiratory arrest.
• paraphrase elements and actions for an effective CPCR.

Course Materials: Course materials will be available in the course library prior to each Real Time Session.

About the Instructor: David Liss has worked in emergency and critical care for over 10 years. He recently sat for the AVECCT exam and speaks nationally on critical care topics. He has also written several book chapters on emergency and critical care. He is the manager of a busy 24 hour referral hospital's ER and ICU departments.

Course Outline:
Week 1 (Real Time Session January 6): Triage, Primary Survey, and ABC's
Content: This session will introduce the concepts of triage, shock, and trauma. Participants will learn the proper physiology behind abnormal TPR values and learn how to properly initially assess critical patients. History taking will also be discussed. Deciding on what level of urgency a patient should be treated will be the main focus.

Week 2 (Real Time Session January 13): Secondary Survey, Tubes, Fluids, and Numbers
Content: The second week will discuss the more thorough secondary survey of a critical patient. At this point, IV access techniques will be discussed. Monitoring modalities such as: SpO2 and Blood Pressure will be discussed in detail. Fluid therapy in the critical patient will also be discussed. Perfusion versus hydration status and "boluses" will be examined. Tricks and tips for catheter placement will also be outlined.

Week 3 (Real Time Session January 20): Specific Interventions with Critical Patients
Content: Week 3 will focus specific interventions with several critical cases. Based on the information the students have received in weeks previous, they will now be able to apply those skills to this section of the course. Trauma (hit-by-car and bite wounds), Gastric Dilatation Volvulus, toxicity cases and a case of feline urethral obstruction will be discussed in detail with regards to presentation, pathophysiology, and assessment/treatment.

Week 4 (Real Time Session January 27): "The Code:" Cardiopulmonary Cerebral Resuscitation
Content: Week 4 will discuss at-risk patients for CPA, CPCR technique, review of drugs and fluid delivery, ECG's, pharmacology, defibrillation, and assessing effectiveness of CPCR. Paradigms for various situations will also be discussed. Finally the "team" approach to CPCR will be stressed.

CE HOURS: 6

Tuition: $120 ($108 early bird special if enrolled before December 16, 2010).
*Students currently enrolled in and taking at least 2 classes or 5 units at an AVMA accredited or CAAHT approved Veterinary Technician Program may be eligible to receive a 50% discount off the regular rate for this course (upon verification of student status). You must include the following information in the comments section of the CE enrollment form in order to be eligible for this discount: your program director's name and contact information (email/phone) and school name.

** To ensure participants are ready and prepared for classes, enrollment will close when the maximum number of participants is reached or at 5pm ET the day of the first Real Time Session unless otherwise noted. If the first Real Time Session is on a weekend, course will close on the Friday before the first Real Time Session.

**For more on how online CE works see the VSPN Participant's Resource Center

TO ENROLL:
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1. Enrollment qualifications: VIN CE courses are open to VIN member and non-member veterinarians. Veterinarians enrolling in a VSPN CE course must be a VIN member. Veterinary support staff must be a VSPN member to enroll in a VSPN CE or a VIN CE course open to VSPN member enrollment.
2. Each enrollee must be able to receive emails from @vspn.org and @vin.com addresses. Email is our major form of communication with participants; personal emails are highly recommended rather than clinic/hospital email addresses.
3. Each person is individually responsible for his/her own registration. To ensure that all information received is secure and correct, please do not enroll for a course on behalf of another individual.
4. For further assistance call 1-800-700-INFO (4636) or email (VIN CE) CEonVIN@vin.com or (VSPN CE) VSPNCE@vspn.org). Please include the course title, your full name, and contact information in your correspondence.

Note: "This course has been submitted for approval for 6 continuing education credits in jurisdictions which recognize AAVSB RACE approval; however participants should be aware that some boards have limitations on the number of hours accepted in certain categories and/or restrictions on certain methods of delivery of continuing education." Call VSPN CE at 1-800-700-4636 for further information. (Attendees are encouraged to check with their licensing jurisdiction(s) for information regarding recognition by their board).

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COURSE WITHDRAWAL AND REFUND POLICY: Withdrawal prior to the listed start date of a course entitles the registrant to a complete refund or a credit toward a future VIN CE course, whichever is preferred. Withdrawal within 1 week after the listed start date (i.e. including no more than one real-time session) entitles the registrant to a credit toward any future VIN CE course. (Refund policy does not apply to courses with only one real-time session.) After the first real-time session, a registrant may withdraw due to special circumstances and receive prorated credit towards a future VIN course. These requests will be handled on an individual basis. The amount of the prorated credit will be determined based on 65% of the time remaining in the course at the time of withdrawal. It is not possible to withdraw retroactively.
Note: To ensure rapid handling of your request for withdrawal, we recommend that you call the VIN office at 1-800-700-INFO (4636).

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** For More Information on VSPN's upcoming CE Courses, check out http://www.VSPN.org/CE

Nanette R. Walker Smith, M.Ed., RVT, CVT, LVT
VSPN Content Director & VSPN CE Director

VSPN CE Services: VSPNCE@vspn.org
1-800-846-0028 or 1-530-756-4881 or direct line to VIN/VSPN from the United Kingdom: 01452226154
Charlotte Waack (Charlotte@vspn.org), ext 193
Chris Upchurch (Chris@vspn.org); ext 197
Darci Palmer (Darci@vspn.org); ext 179
Debbie Bess (DBess@vspn.org); ext 178
Mary Mould (Mary@vspn.org); ext 159
Nanette Walker Smith (Nanette@vspn.org); ext 187

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